Defending COVID-19 policies against legal challenges, government officials relied heavily on Jacobson v. Massachusetts, a 1905 case in which the U.S. Supreme Court upheld a smallpox vaccine mandate imposed by the Cambridge Board of Health. But the breadth of the license granted by that decision is a matter of dispute, even as applied to superficially similar COVID-19 vaccination requirements. Critics of those mandates argued that COVID-19 shots, unlike smallpox vaccination, do not prevent transmission of the disease, which means that requiring them amounts to paternalistic intervention rather than protection of the general public.
Last week in Health Freedom Fund v. Carvalho, the U.S. Court of Appeals for the 9th Circuit dismissed that distinction as constitutionally irrelevant. Rejecting a challenge to a COVID-19 vaccine mandate that the Los Angeles Unified School District (LAUSD) imposed on its employees in 2021, the majority held that the district "could have reasonably concluded that COVID-19 vaccines would protect the health and safety of its employees and students." The implications of the 9th Circuit's decision for the right to bodily integrity are alarmingly broad, since the court's logic would seem to bless all manner of medical mandates that the government views as beneficial to the patient, regardless of any purported effect on third parties.
The plaintiffs in the 9th Circuit case, including LAUSD employees who were fired because they refused to comply with the vaccine requirement, argued that Jacobson did not authorize that policy. Their case features dueling interpretations of Jacobson that in turn reflect different understandings of "public health." Is that rationale for government action limited to external threats such as those posed by disease carriers and air pollution, or does it extend to self-regarding decisions such as lifestyle choices and consent to medical treatment? The 9th Circuit's ruling implicitly embraces the latter view, which invites far-ranging, open-ended interference with individual freedom.
